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Korean Journal of Reproductive Medicine 2007;34(4):305-312.
Published online December 1, 2007.
Efficacy of the Split Insemination Method Combining Conventional IVF and ICSI in Non-male Factor Infertile Couples with Normal Sperm Parameters.
Seung Bum Hong, Dong Wook Park, Mi Ra Shin, Su Jin Choi, Sun Hee Lee, In Ok Song, Jin Hyun Jun
1Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
2Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
To evaluate the efficacy of split insemination method in treatments for non-male factor infertility. METHOD: Laboratory and clinical data were collected from 505 cycles of split insemination during 2002~2005 in our center. The subjects were non-male factor infertility such as endometriosis, tubal, uterine, PCOS and idiopathic infertility without any sperm defects. Retrieved oocytes were randomly divided, and inseminated by conventional IVF or ICSI. Fertilized zygotes were cultured for 2~5 days to ET date, and surplus zygotes and embryos were frozen for subsequent frozen-thawed ET cycles. Clinical outcomes according to insemination method were compared by statistical analysis. RESULTS: The overall fertilization per retrieved oocytes was significantly higher in ICSI than that of conventional IVF in sibling oocytes (62.5+/-22.3% vs 52.9+/-28.0%, p<0.01). Total fertilization failure occurred only in 2 of 505 cycles (0.4%) in split insemination cycles. Incidence of fertilization failure and poor fertilization rate less than 30% by ICSI were significantly lower than those of conventional IVF (1.1% and 7.5% vs 8.5% and 22.0%, p<0.01). Delivery rates after transfer of fresh and thawed embryos from split insemination cycles were 40.0% (185/462) and 35.0% (55/157), respectively. There was no significant difference in the implantation and delivery rates of ET with embryos from conventional IVF or ICSI. CONCLUSION: Taken together, the split insemination method improves poor fertilization rates resulting in successful clinical outcomes and thus could be used for non-male factor infertile couples in human ART program.
Key Words: Split insemination; ICSI; Conventional IVF; Fertilization failure; Fertilization rate; Clinical outcomes
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